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Meta-Analysis
. 2017 Sep 9;6(9):e005947.
doi: 10.1161/JAHA.117.005947.

Relationship of Sleep Duration With All-Cause Mortality and Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies

Jiawei Yin  1   2 , Xiaoling Jin  1   2 , Zhilei Shan  1   2   3 , Shuzhen Li  1   2 , Hao Huang  1   2 , Peiyun Li  1   2 , Xiaobo Peng  1   2 , Zhao Peng  1   2 , Kaifeng Yu  1   2 , Wei Bao  4 , Wei Yang  1   2 , Xiaoyi Chen  5 , Liegang Liu  6   2
Affiliations
Meta-Analysis

Relationship of Sleep Duration With All-Cause Mortality and Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies

Jiawei Yin et al. J Am Heart Assoc. .

Abstract

Background: Effects of extreme sleep duration on risk of mortality and cardiovascular outcomes remain controversial. We aimed to quantify the dose-response relationships of sleep duration with risk of all-cause mortality, total cardiovascular disease, coronary heart disease, and stroke.

Methods and results: PubMed and Embase were systematically searched for prospective cohort studies published before December 1, 2016, that examined the associations between sleep duration and at least 1 of the 4 outcomes in generally healthy populations. U-shaped associations were indicated between sleep duration and risk of all outcomes, with the lowest risk observed for ≈7-hour sleep duration per day, which was varied little by sex. For all-cause mortality, when sleep duration was <7 hours per day, the pooled relative risk (RR) was 1.06 (95% CI, 1.04-1.07) per 1-hour reduction; when sleep duration was >7 hours per day, the pooled RR was 1.13 (95% CI, 1.11-1.15) per 1-hour increment. For total cardiovascular disease, the pooled RR was 1.06 (95% CI, 1.03-1.08) per 1-hour reduction and 1.12 (95% CI, 1.08-1.16) per 1-hour increment of sleep duration. For coronary heart disease, the pooled RR was 1.07 (95% CI, 1.03-1.12) per 1-hour reduction and 1.05 (95% CI, 1.00-1.10) per 1-hour increment of sleep duration. For stroke, the pooled RR was 1.05 (95% CI, 1.01-1.09) per 1-hour reduction and 1.18 (95% CI, 1.14-1.21) per 1-hour increment of sleep duration.

Conclusions: Our findings indicate that both short and long sleep duration is associated with an increased risk of all-cause mortality and cardiovascular events.

Keywords: all‐cause death; cardiovascular disease; coronary heart disease; meta‐analysis; sleep; stroke.

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Figures

Figure 1
Figure 1
Flowchart of article selection. CHD indicates coronary heart disease; CVD, cardiovascular disease.
Figure 2
Figure 2
Nonlinear dose‐response analyses of sleep duration and risk of all‐cause mortality (A), total CVD (B), CHD (C), and stroke (D). CHD indicates coronary heart disease; CVD, cardiovascular disease.
Figure 3
Figure 3
The forest plots between sleep duration (per hour) and risk of all‐cause mortality for short sleep (A) and long sleep (B). CI indicates confidence interval.
Figure 4
Figure 4
The forest plots between sleep duration (per hour) and risk of total cardiovascular disease for short sleep (A) and long sleep (B). CI indicates confidence interval.
Figure 5
Figure 5
The forest plots between sleep duration (per hour) and risk of coronary heart disease for short sleep (A) and long sleep (B). CI indicates confidence interval.
Figure 6
Figure 6
The forest plots between sleep duration (per hour) and risk of stroke for short sleep (A) and long sleep (B). CI indicates confidence interval.
See this image and copyright information in PMC

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